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Hematidrosis, hematohidrosis and hemidrosis—these are all names for one rare disease that makes the patient excrete blood from intact skin. Without any open lesions or wounds, it would seem that the patient is sweating blood. Blood would leach out from the body’s orifice like eyes and ears—with palms and hands being common outlets.

She was reportedly to have had hematohidrosis for the past three years, sweating blood from her hands and face without any prompt. The bouts would last one to five minutes and would come on at various settings – including while exercising, sleeping, and especially when she was under emotional stress.

Dr Michelle Sholzberg, co-director of the Hemophilia Comprehensive Care programme at St Michael’s Hospital in Toronto remarked, “I think this person has a very bizarre anatomical defect on a microscopic level that is resulting in this very unusual symptom.”

A 21-year-old woman was diagnosed with hematohidrosis, causing her to ooze blood from unbroken skin. Photo credit: Canadian Medical Association Journal/CTV

More than sweating blood

Hematohidrosis is rarely reported, but it has been in writing since Aristotle’s day in third century BC. In the crucifixion of Jesus Christ, it was also said that he had experienced hematohidrosis. Later in the 1600s, hematohidrosis started to appear in the medical context. Off late, there has been an increase in reported cases of hematohidrosis.

Dr Jacalyn Duffin, a medical historian and haematologist at Queen’s University in Kingston, Ontario said that there have been 42 reported cases of hematohidrosis in medical literature since 1880. In 2013 alone, there have been 18 reported cases of the disease – with more cases reported in young women than men.

The causes for hematohidrosis are hypothesized to be many, yet undetermined. In one, where hematohidrosis occurs in patients under high amounts of stress, the multiple net-like blood vessels around the sweat glands rupture due to the constriction that took place under great stress. The blood will then travel with the sweat produced by the sweat glands and ooze out from the face and palms.

Other possible causes include the sympathetic nervous system going into overdrive. Under anxiety and stressful mental contemplations, the body’s ‘fight or flight’ response is invoked to a degree that causes haemorrhage of the blood vessels.

Some others would also theorise that hematohidrosis is due to a bleeding disorder, where the blood did not coagulate as it should, or it could also be attributed to high blood pressure.

Another case of hematohidrosis observed in a 7-year-old girl from Thailand. Photo credit: Daily Mail

Hematohidrosis hurting the mental well-being

Hematohidrosis has been thought to be non life-threatening. It does, however, leave a patient dehydrated and lethargic from the bouts of anxiety and the loss of both blood and sweat. In the 21-year-old woman’s case, hematohidrosis seems to have an adverse psychological effect. She reported being a social recluse due to the embarrassment of her condition, with her complaints being consistent to that of those having major depression and panic disorder.

Treatment remains vague for hematohidrosis, with medical professionals unable to find a cure just yet. To stop bleeding from the skin’s surface – otherwise saying to alleviate the symptom and not to completely wipe off the disease – the underlying stressor that is triggering the disorder is addressed. There has been success with the use of high blood pressure medication, causing marked reduction in bleeding. Antidepressants are used to treat the psychogenic causes and symptoms. MIMS

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